天花粉蛋白两种方法治疗输卵管妊娠的临床观察

Clinical observation on the effects of 2 different trichosanthin medications on tubule pregnancy

目的通过观察天花粉蛋白孕囊内介入治疗和宫颈注射治疗输卵管妊娠的疗效和不良反应,探讨孕囊内注射天花粉蛋白的临床价值,比较2种治疗方法的疗效。方法未破裂型输卵管妊娠患者95例,在患者知情同意的情况下,39例行孕囊内注射(孕囊组),56例行宫颈注射(宫颈组),2组患者年龄、孕次及一般资料差异均无统计学意义。比较2组治疗的成功率、血中人绒毛膜促性腺激素β亚单位(β-hCG)恢复到正常(≤100 U/L)的时间、患者住院时间以及不良反应发生情况。结果孕囊组和宫颈组治愈率分别为97.4%与71.4%,差异有统计学意义(P<0.05);孕囊组β-hCG恢复到正常的时间(14.5±7.2)d,住院时间(7.3±3.0)d,均显著少于宫颈组的(20.6±9.3)d和(15.6±6.0)d,2组比较差异有统计学意义(P<0.05);孕囊组腹痛发生率(82.1%)明显高于宫颈组(19.6%),差异有统计学意义(P<0.05),其他不良反应发生情况2组差异无统计学意义。结论相对于宫颈注射治疗天花粉蛋白治疗输卵管妊娠,孕囊内注射天花粉蛋白介入治疗起效快、疗程短,对于未破裂型输卵管妊娠具有更好的治疗效果。

Objective To observe the therapeutic effects and side effects of pregnant sac trichosanthin（TC8）intervention and TCS intracervical injection in the treatment of tubule pregnancy, to explore the clinical value of pregnant sac TCS injection in the treatment of tubule pregnancy, and also to compare the therapeutic effects of 2 different treatment methods. Methods There were a total of 95 ca ses of disrupted type tubule pregnancy in our study. With the knowledge and consent of the patients, 39 cases of tubule pregnancy were given pregnant sac TCS injection （the pregnant sac injection group） and 56 cases were given intracervical injection （the intracervical in jection group）. There was no statistical significance in the age, the frequency of pregnancy and general medical data. Then, success rates, the time taken for the recovery of β-hCG, the length of hospital stay and side effects were compared between the 2 groups. Results Cure rates for the pregnant sac injection group and the intracervical injection group were 97.4% and 71.4% respectively, with statisti cal significance （P 〈 0.05）. The time taken for the recovery of β-hCG to normal level was （14. 5 ± 7.2） days in the pregnant sac injec tion group and the duration of stay in the hospital was （7.3 ± 3.0） days, which were all significantly shorter than （20.6 ± 9.3 ） days and （15.6±6. O） days of the intracervical injection group. Statistical significance could be seen, when comparisons were made between the 2 groups （P 〈 0.05）. And no marked differences could be noted in side - effects. Conclusion In relation to intracervical injection for the treatment of tubule pregnancy, pregnant sac TCS intervention could produce quick response and had shorter treatment duration. For this reason, the method of pregnant sac TCS intervention was more valuable for the treatment of disrupted type tubule pregnancy.